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Dialysis access: an increasingly important clinical issue

Maurizio Gallieni1, Alma Martini, Nicoletta Mezzina

  • 1Nephrology and Dialysis Unit, San Carlo Borromeo Hospital, Milan, Italy. gallieni.maurizio@sancarlo.mi.it

The International Journal of Artificial Organs
|December 29, 2009
PubMed

Insights

Optimizing dialysis access, including hemodialysis vascular access and peritoneal dialysis access, is crucial for end-stage renal disease patients. This review addresses key issues like catheter overuse and access surveillance to improve patient outcomes.

Area of Science:

  • Nephrology
  • Vascular Surgery

Background:

  • Dialysis access is critical for end-stage renal disease (ESRD) patients.
  • Suboptimal access is linked to increased morbidity, mortality, and healthcare costs.

Purpose of the Study:

  • To review current challenges and best practices in dialysis access.
  • To address issues including peritoneal dialysis prevalence, central venous catheter use, steal syndrome, antiplatelet therapy, and access evaluation.

Main Methods:

  • Literature review of recent publications on dialysis access.
  • Analysis of problematic issues in hemodialysis and peritoneal dialysis access.

Main Results:

  • Peritoneal dialysis use is low in Western countries.
  • Central venous catheter use is excessively high in dialysis patients.
  • Key areas for improvement include pre-dialysis access planning, diagnosis/treatment of steal syndrome, antiplatelet therapy, and access surveillance.

Conclusions:

  • Improving dialysis access strategies is essential for better ESRD patient care.
  • Addressing current challenges can reduce associated morbidity, mortality, and costs.

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